Session Type: Abstract Submissions (ACR)
Background/Purpose: Due to their anti-inflammatory effects, statins were proposed to lower the incidence of connective tissue diseases (CTD). The objective of this study is to determine if statin use is associated with a lower incidence of CTD in a healthcare setting where patients have similar access to care.
Methods: This was a retrospective analysis of adult patients (30-85 year-old) enrolled as Tricare Prime in a military medical facility. The study period was divided into baseline period (10/1/2003 to 9/30/2005), and follow up period (10/1/2005 to 3/5/2010). “Statin Users” received and dispensed a statin prescription of at least 90 days during the period from 10/1/2004 to 9/30/2005. “Non-users” did not receive a statin at any time during the study period. The outcome measure was the occurrence of any diagnosis code of the International Classification of Diseases, 9th Revision, Clinical Modification(ICD-9-CM) consistent with CTD (Rheumatoid arthritis and related disease, Systemic lupus erythematosus, and other connective tissue diseases as identified by the Clinical Classification Software of the Agency for Healthcare Research and Quality). We described comorbidities during the baseline period using the Charlson comorbidity score (CCS). We repeated the analysis in a prespecified subgroup of patients with CCS of 0 (no comorbidities).
Results: 46,488 patients were included: 13,640 statin-users and 32,848 non-users. Statin users were predominately male (58.3% vs 43.8%), older (60.4 years vs 44.8 years), smokers (9.0% vs 5.8%) and had a higher average CCS (1.2 vs 0.3) (p<0.0001). In the subgroup with no comorbidities, there were 6,137 statin users and 27,626 non-users. Regression analysis showed that statin users had a statistically significant lower incidence of connective tissue disease (adjusted odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.73 – 0.96; p-value=0.01). However, in the subgroup with no comorbidities, there was no difference between statin users and non-users in the incidence of CTD (adjusted OR: 0.83; 95% CI: 0.67 – 1.04; p-value=0.1).
Conclusion: Statin use is not associated with a lower incidence of CTD in patients without comorbidities. This finding may suggest that the beneficial effect of statins on CTD in many studies may be due to unadjusted baseline confounders or healthy user bias.
T. W. Schmidt,
D. F. Battafarano,
C. R. Frei,
E. M. Mortensen,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-statins-reduce-the-incidence-of-connective-tissue-disease-a-retrospective-cohort-study/